Speeches

Alcohol Action Ireland Conference ‘Facing the Fear’ Alcohol and Mental Health in Ireland Speech by Minister of State at the Department of Health Alex White, T.D.

Introduction

Good morning ladies and gentlemen, I would like to thank Suzanne Costello for inviting me to open this conference and to take the opportunity to acknowledge Alcohol Action Ireland for the work you do in raising public awareness of the harms caused by alcohol.

This year’s conference is of particular interest as it brings a focus to the damaging impact that alcohol abuse has on mental health and the role that alcohol plays in suicide and self-harm, particularly among our young people. These are important, timely and relevant topics and I commend Alcohol Action Ireland for hosting this conference and highlighting this issue.

Harms of Alcohol

Ireland has a problem! We drink too much alcohol and many people are in denial about this. It is time to face up to the facts – 1.5 million people drink in a harmful pattern. We consume on average 12 litres of pure alcohol per person over the age of 15 per year. That’s equivalent to almost a bottle of vodka per week.

This pattern of drinking is causing significant harm to individuals, their families and society. Allow me to take a few moments to reiterate some of the harms that alcohol causes. The National Substance Misuse Strategy Steering Group reported that alcohol:

  • Was responsible for at least 88 deaths every month in 2008; and
  • is associated with 2000 beds being occupied every night in Irish acute hospitals;
  • Alcohol is a contributory factor in half of all suicides and in deliberate self-harm and 1 in 4 deaths of young men were estimated to be due to alcohol in 2008;
  • Alcohol was a trigger in a third of domestic abuse cases;
  • Alcohol related illness cost the healthcare system €1.2 billion in 2007.

The aim of this conference is to raise awareness of the impact that alcohol has on mental health and the devastating consequences of this. The associated facts are startling:

  • Alcohol was a factor in 40% of all cases of self-harm in 2010;
  • alcohol-related disorders accounted for 1 in 10 first admissions to Irish psychiatric hospitals in 2011;
  • the WHO has estimated that the risk of suicide is eight times greater when a person is abusing alcohol; and
  • half of all those who took their own lives in Ireland had abused alcohol in the previous 12 months.

And, let us not forget that suicide is tragically the leading cause of death among young Irish men aged 15-24.

I would particularly like to thank John Higgins for speaking here today and humanising these statistics by sharing his personal story.

Public Health Alcohol Bill

So, what can we do to reduce the harm caused by alcohol? This Government is committed to tackling alcohol misuse in Ireland and the widespread harm and pain it causes. Last month, following much consultation and dialogue between Government Ministers and Departments, a comprehensive and detailed package of measures was approved to address this problem. It is the first time the misuse of alcohol has been addressed as a public health issue.

The alcohol problem in Ireland, as I have said already, is significant and we need decisive and innovative action to address it. The overall objective is to reduce the consumption of alcohol in Ireland from 12 litres of pure alcohol per person per year to 9.2 litres (the OECD average) by 2020. The package of measures has been framed with this in mind.

The key measure is the drafting of health-oriented legislation on alcohol – the Public Health (Alcohol) Bill. This Bill will be drafted taking into account the recommendations of the National Substance Misuse Strategy Steering Group Report.

The Bill will provide for:

  • Minimum unit pricing for retailing of alcohol products;
  • Regulation of marketing and advertising of alcohol;
  • Regulation of sports sponsorship, specifically to place an existing voluntary code that governs sports sponsorship on a statutory footing;
  • Separation of alcohol from other products;
  • Enforcement powers for Environmental Health Officers in relation to alcohol; and
  • Health labelling of alcohol products.

Minimum Unit Pricing

I would like to briefly address what I believe is one of the anchors of this package – minimum unit pricing. As you may be aware, this is a mechanism of imposing a statutory floor in price levels for alcohol products that must be legally observed by retailers.

Taken in conjunction with the other measures, it has the potential to have a real impact on the harmful and hazardous consumption of alcohol. Hazardous drinkers tend to purchase the cheapest alcohol, and therefore, increasing the price of alcohol is an effective means of reducing consumption. It would also have a greater impact on discouraging children to drink.

Minimum unit pricing targets alcohol that is cheap relative to its strength and is one of the methods employed to tackle the very low cost at which alcohol is sold in the off-trade sector – particularly in supermarkets.

We are well underway with developing the legislation on minimum unit pricing.

Pattern of alcohol consumption

In recent years, there has been a significant shift in the sale of alcohol to off-sale premises. Alcohol in this environment is cheaper and easier to access, particularly for young people, and less supportive of employment in the hospitality sector. The Public Health Alcohol Bill will help to rebalance this pattern towards more sales through the on-trade and, by retailers whose core business is the sale of alcohol. I have no doubt that this will help to encourage more responsible and appropriate patterns of consumption of alcohol.

Protection of Children

It is important that we protect our children from the harms of alcohol. Irish children are drinking from a younger age and drinking more than ever before with over half of Irish 16 year olds reporting been drunk at some point and one in five is a weekly drinker. As we will hear later today, this can have a devastating impact on their mental health.

The advertising and marketing of alcohol is particularly attractive to young people, no more so than in the context of its association with sport.

I am pleased to inform you that under the Public Health Alcohol Bill alcohol advertisements on TV and radio will be incrementally restricted to evening hours by 2016. Statutory codes of practice are also envisaged for the print media and cinemas which will also cover the manner in which alcohol is portrayed in advertisements. The legislation will also cover billboard and other outdoor advertising media. The existing voluntary code of practice governing sports sponsorship will be given statutory status. Meanwhile, a working group chaired by the Department of An Taoiseach will report within 12 months on the implications of regulating sponsorship by alcohol companies of major sporting events.

Mental Health

There was a time in Ireland when we were embarrassed to discuss personal mental health problems. But things are changing. These days it is quite common to hear people talking about their mental health issues in a very matter of fact way on a radio or TV programme. This is a positive change – it normalises mental illness. I genuinely feel that through See Change the National Stigma Reduction Campaign, we are making progress in tackling the problem of stigma. Obviously we still have a way to go but I am satisfied that we are heading in the right direction.

The Government, in line with A Vision for Change, has prioritised the reform of our mental health service. In this regard funding of €90m has been made available since 2012 up to the end of 2014, which has been specifically ear-marked for mental health and suicide prevention.

Reach Out, our National Strategy for Action on Suicide Prevention, makes a number of recommendations in relation to fast track referrals to community-based mental health services; effective response to deliberate self-harm; training and stigma reduction. The National Office for Suicide Prevention has developed a range of initiatives to support people who are suicidal and also to support their families, friends and peers in recognising and responding appropriately to signs of emotional distress and suicidal thoughts.

Mental Health and Alcohol

This conference highlights the relationship between alcohol and mental health issues. The National Substance Misuse Strategy steering group were mindful of the impact of alcohol on mental health when making their recommendations in regard to treatment and rehabilitation. The report recognises that mental health problems which co-exist with alcohol misuse can have a significant impact on the treatment and long-term outcome of the alcohol related problem.

The following recommendations of the National Substance Misuse Strategy Steering Group, which have been endorsed by Government, specifically relate to mental health services and will be progressed by the HSE:

  • To develop joint protocols between mental health services and drug and alcohol services with the objective of integrating care planning, and to improve the outcomes for people with co-morbid severe mental illness and substance misuse problems;
  • To establish a forum of stakeholders to progress the recommendations in A Vision for Change in relation to establishing clear linkages between the addiction services, primary care services, community mental health teams and specialist mental health teams. This will facilitate the development of an integrated approach to service development including:
    • developing detoxification services;
    • ensuring availability of, and access to, community-based, appropriate treatment and rehabilitation services through the development of care pathways; and,
    • ensuring access to community mental health teams where there is a co-existing mental health condition.

Conclusion

We know about the adverse effects of alcohol consumption on children, families and communities and the impact it can have on mental health. The time has come to act. We should proceed by consensus as far as we can. But, to be effective we will have to be radical. The nature of the challenge we are addressing requires a significant public health response. This is what the government has agreed and I hope and believe that, with the help of conferences such as this, it will gain the support of the broader community and society. You can be assured of the Government’s unwavering commitment to addressing this issue. Thank you for your attention.